Crosswalk: Attachment C

Rev

Title changed to reflect change in the name of
the data collection instrument.

Table displaying
Credibiility Adjustment
Factors

Removed

Del

This table now appears in the MLR Report
Workbook. The MLR Report Workbook
software computers the applicable credibility
adjustment factor for each contract based on
other user inputs.
The MLR Report Workbook adds Worksheet
3, which was not part of the MLR Data Form.

Reason for
Change

2018 (new version)
Title: MLR Report Filing
Instructions

Type of Change

2016 (old version)
Title: MLR Data Form
Filing Instructions

Instructions for
Worksheet 3 Description of Expense
Allocation Methods
Line-by-line instructions for Line-by-line instructions
completing
for completing
MLR Data Form
MLR Report Workbook

Add

Rev

The instructions have been amended to reflect
changes to the layout of the data collection
instrument and the addition of many data
fields that were not in the MLR Data Form.

Section explaining
"ADDITIONAL
INFORMATION
REGARDING MLR
CALCULATIONS"

Del

This is section that described changes in how
the MLR is reported as a result of policies
finalized in the April 2, 2018 final rule (CMS4182-F), including the reduction in the amount
of MLR Data CMS colllects. This section also
described technical changes in MLR reporting
related to the replacement of the MLR Report
Workbook with the MLR Data Form, starting in
CY 2018. We are deleting this section as it is
inconsistent with our proposal in the January
6, 2022 proposed rule (CMS-4192-P) to
reinstate the detailed MLR reporting
requirements that were in effect for CYs 2014
through CY 2017.

N/A

Removed

Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.

No

No

No

Yes

No

Burden Change